Centrist Pundits

Centrism is, at times, a powerful force for good.  If for no other reason than most Americans are not radicalized to the left or the right, finding the center and acting on that moderate agenda is often an effective means to the end of moving forward, but not leaving people behind.  That said, centrism and moderation have their own flaws as well, and we’d be foolish not to acknowledge them.

The bill currently moving through the Senate is an example of one problem with centrism: it can leave no one happy.  Progressives are saying it doesn’t do enough, conservatives are afraid it does to much, and the middle… well, we don’t seem to think its going to accomplish anything at all, except make things more expensive.

And who can blame us?  Weve seen Washington bail out Wall Street without passing any reform, and they are just back to their old tricks.  We’ve seen a job stimulus that may or may not be working – but the website that went to show us it was working had an extra 440 Congressional Districts on it.  And we’ve seen credit card reform pass in such a way that the cards had time to raise their rates more than double before it was enacted, to insulate themselves from the real effects of that reform.  Is there any chance Health Care reform can do any better?

If we take away the option from Health Care companies to drop our coverage if we get a bad condition or to deny us coverage in the first place, that sounds good, but its subverted by the fact they can still raise our rates to price us out of coverage.

If we mandate coverage for all Americans but don’t make coverage affordable, what have we really accomplished?

I want health care reform, and I didn’t necessarily need to see a public option, although I generally support one.  But passing only part of a set of laws, in the name of political expediency, because Senate rules allow one or two people a large amount of power, isn’t a good way to do things.  It looks like centrism – “moderates and Republicans forced the Democratic bill to the center” – but it isn’t in the middle in any logical, thought out way.  It is more like if the bill had been given to a mad barber.

Perhaps this is one reason why no one thinks well of the middle – nothing gets there unscathed.

JC Congress, Health care

I’ll try to take the time to look over Obama’s speech more closely, to examine the good and the bad, and what works for Centrists, when I have a little more time.  For now, let me just say, no matter what party the President is, no matter how much you disagree with him… you don’t heckle him at a joint session of Congress.

To be fair, I think Representative Joe Wilson has realized that.  His apology actually did sound sincere.

I wonder if John Boehner even knew he was on camera when he let out a heavy sigh when Obama referred to the fact that the last administration and the Congress is had didn’t try to pay for programs as they went.

In a perfect world, no one would interrupt non-Presidents outside of joint sessions, either – like the town hall problem.  Unfortunately, the extremes of both parties seem to have decided that being the noisiest is equal to being the winner.

Huh.  I wonder.  Maybe the reason the Center is never taken seriously is because its hard to be “extreme” as a centrist.  What would we yell?  ”MAKE FISCALLY RESPONSIBLE BUT SOCIALLY CONSCIONABLE CHOICES NOW!”

JC Congress, Health care, Personalities centrism, Health care, obama

Obama is preparing for a major speech on health care, bringing the debate back to Washington after a month in the town halls across the nation.  While I’m still busy in a job transition, it is Labor day and I have time to write something.

I’m all for single payer, Canadian style.  That’s never really been on the table.  Failing that, I’m all for a public option, and while Obama is supposedly going to make a case for it tomorrow, it probably doesn’t have the popularity to become law.  But my main concern is this: I’m all for other reform, as well.  And I don’t know if other reforms will come when what is considered the main reforms by the party in power fall short.

Because while I may consider the public option needed, I still want and think we need torte reform.  I still want and think we need to fix the problems with pre-existing conditions and with insurance companies dropping some people when they get sick.  We need to fix the fact that medical decisions aren’t made by doctors, and that medication is too expensive.

I don’t know what will happen, and any pundit who tells you they do is a liar.  The situation is complex and ever evolving.  Where we go from here is up to the people in Washington, but send your letters anyway.  It can’t hurt and it could conceivably help.

JC Health care Health care, obama

The White House has launched a website called “reality check” which is specifically designed to fight the more outrageous nonsense in the health care debate.  (Insert partisan politics here)

You can see the site here: http://www.whitehouse.gov/realitycheck/

That said, ignoring the politics, I have to agree with a pundit I was reading this morning.  I’m not sure this debate is in the realm of facts any more.  I’m not sure it can be won by proving what is true or by being correct.

I suppose we shall see.

JC Health care Health care, obama

Okay, I think a lot of people who are educated about such matters know that the debate on health care, while valid, is intensely over-inflated.  The rhetoric at times borders on the insane.  I’ve already commented on that.

Of course, it hit kind of a new height over the weekend as Sarah Palin tried to convince Americans – actually, I should probably take out “tried”, as I’m sure some believe her – that Obama’s “death panels” would make decisions on who lives and who dies, and that they would probably come for her son, Trig, as being special needs, he’s expensive.

I’m going to leave aside the part about going after Trig, because it isn’t funny, it is sad.  Either she really believes that Obama is going to kill her child, which is sad, or she knows better and is just scoring points, which is frustrating.

But death panels, now that’s funny.  It is so over the top and crazy sounding that all that is left to do is laugh.  It is completely obviously untrue.  But let’s say it is true; I hope I get that job.  First of all, I bet they get great health benefits.  Secondly, I bet they get to wear all black and look genuinely cool.  Thirdly, power of life and death is, well, power, and there’s certainly people I could imagine putting on the “denied” list.  But fourthly, and most of all, they have a great job title.  Formally, I imagine that a business card that says “Death Panelist” is intimidating enough, but what’s more important is that informally, America would no doubt call them Reapers.

“My name is (your name), and I’m a Reaper.”  Don’t tell me it doesn’t give you at least a little thrill to say it.

JC Health care Health care, Palin, rhetoric

Almost everyone agrees we need health care reform in this country.  The agreement is widespread as both a moral imperative (why can’t we care adequately for the least of us?) and as a financial need, with health care costs ever rising, ever consuming more of our nation’s available capital.  The how is, of course, still in question, but the need is beginning to cement itself in everyone’s minds.  Even in lobbyist-driven Washington, the fact that a vast majority of Americans are demanding change is beginning to override the power of lobbyists, though to be fair the lobbies are quite willing to pour more money in to the fight.

My problem with all of it is not that it isn’t needed – it is – but in that we’re trying to talk about it like we can predict exactly what will happen.  It will cost a Trillion dollars… maybe.  But that might be offset by savings… maybe.  We’ll get that money from taxes on the wealthy that will be triggered only if need be… maybe.  These costs will adversely affect small businesses and cost jobs… maybe. 

We tend to put a lot of trust in the Congressional Budget Office.  The CBO is a great group, no doubt, being non-partisan and just being a bunch of people with no real agenda who add up numbers on various scenarios.  As more information is given to them, they come up with different and presumably more accurate information about how much various government programs will cost.  But the CBO isn’t perfect – for either party – because while costs are somewhat predictable, the economy as a whole, and indeed the nation as a whole, is a chaotic system.

I don’t mean chaos in a bad way, I mean it in the scientific way.  We all know the basics of chaos – a butterfly farts in Japan and there is a hurricane in Florida.  More specifically, it was discovered when scientists learned that for complex systems, changing the input even a very small amount – like changing the input data from 4 decimal places to 5 – can lead to massively different results over time, results that don’t even resemble each other after just a few years.  The economy is very much a complex system, and is intricately bound to human behavior, another extremely complex system.

We don’t know how many people will join the public option.  We don’t know how many small businesses will have trouble.  We don’t know so many things about health care and the economy, but you know what?  It doesn’t quite matter.  We don’t know a lot of things.  We can only make our best guesses, and act on them in good faith.

Though I will say this.  Tom Coburn, Republican Senator from Oklahoma, put a clause in the senate version demanding that members of Congress and their staff be on the public option, if one exists.  The cynics out there would say that this is to scare members of Congress in to not voting for it, because they wouldn’t want to lose their fancy health benefits.  But I think it is a brilliant idea just at face value.  Why shouldn’t our public officials be on the public option?  Would that not guarantee that our public option is up to their standards?  Senators Dodd and Kennedy got behind the idea.  So should every Democrat.  It’s a good one.  Thank you, Senator Coburn – now get back to work on your Ricky Ricardo impression.

JC Economy, Health care CBO, chaos theory, Health care, senators

There are, it seems, only two major stories to follow in the world these days.  Domestically, to the United States, there story of the day is health care reform, and overseas, the story is Iran.

There isn’t much to say about Iran, really, except that we can hope and pray, as you prefer, that the violence there is minimal, and that the outcome is right.  We can express our support for peace, we can express our doubts about the election’s legitimacy, but in the end, we can’t do much there.

Health care, on the other hand, is really coming home to me this week.  What should be done is a bit beyond my pay grade, but I can tell you this, and it is something we all know deep down, and it is something we all need to acknowledge – health care in this nation is screwed up beyond measure.

We could make a list of all the ways it is messed up, and this being a political blog, there isn’t really a space limitation, but sometimes, some of the ways it is messed up are made more obvious than others.  Today, it is on how insurance drives health care decisions, rather than health care needs driving health care decisions.

Totally true story – not me, in case anyone is wondering.  Man walks in to doctor’s office.  Man gets tested.  Man has a large mass of cancer but it hasn’t spread yet.  Man is discussing treatment options with the doctors.  Recommendation is chemo and radiation, then surgery, then more chemo and radiation if needed.  This is the medically best option.  Then the man mentions that while he has insurance now, he may not have insurance next month due to circumstances beyond his control.  Well then, the doctors say, let’s do the surgery now.  Chemo and radiation can be cost controlled, but there’s just no way to get the surgery without insurance.

Does anyone else see the problem there?  I’m not saying surgery now is a bad choice, medically.  I’m saying this gentleman is being denied the best course of treatment because of his insurance situation.  I know we aren’t a socialist society, but how can we stomach the fact, how can we live with ourselves, saying it is okay to treat people differently when they are sick, based on their financial situation.  If this man didn’t have insurance now, he wouldn’t even be being offered this second-best option, he’d have to wait until something ruptured so he could get in an emergency room.

I mentioned in a previous column that one of the talking points is avoiding putting a bureaucrat between you and your doctor.  Our current health care system has gone beyond that step – we don’t even need the bureaucrat any longer to know that we don’t have access to the best care.  I believe it when people talk about America having the best health care in the world.  I just can’t stomach that it is only for those who can afford it.

The economy sucks right now.  We all know that.  You may not have a job next month.  I may not have a job next month.  You may not have insurance next month, whether or not you have a job.  Do you really want a guy performing surgery on you now because he may not be allowed next month, when that may not be the best option?  Because that’s the America we live in.  Think about that.

And in case you’re wondering about my tone, you’re damn right I’m angry.

And to my friend, the sample case here, and his wife – Good luck, and God Bless.

JC Health care Health care

We all know why talking points exist.  It is a twofold, reason, really – one is that when someone hears a good argument, they like to use it themselves.  I’ve been known to do that myself.  For example, when I say that I don’t understand why America can’t provide health care to all the people of America when other countries can do it, that isn’t original to me.  The other reason is because, well, sometimes, repetition makes things true, or at least, makes things seem true.  If enough people say “Eggs are bad for you” then people are going to start thinking eggs are bad for you, whether or not eggs are good or bad.  The real reason why talking points exist is because, well, they work.

Still, it seems to me you’d want to evaluate if your talking points really make any sense at all.  I know “The Daily Show” did a routine on this last night, but I thought it deserved some further consideration.  The talking points for the opposition on how the President wants to change health care seem to be “Do you really want health care to be as efficient as the DMV (or other government office)?” and “Why would you want to insert a bureaucrat between you and your doctor?”

That second one is nonsense.  There’s already a bureaucrat between me and my doctor, and he works for an insurance company.  Actually, my insurance is pretty good now, but back in the day, I had to fight for things like chiropractic visits.  And if I wasn’t fighting, I was constantly getting re-evaluated to see if they were still needed.  Because some guy who’s never met me or talked to my doctor has a computer formula that says I might be scamming the insurance company out of money with unnecessary visits… as if going to a doctor is a fun way to spend my time.  I wasn’t going to an amusement park; I was going to an office, waiting for 15 minutes to half an hour, for a 5-10 minute appointment that helped me continue to be able to use my arm.  So you know what?  I’ll gladly take the government bureaucrat instead, and I’ll tell you why.  Because that government worker at least in theory works for the people while the insurance company one works only for stockholders who have the sole interest in saving money, not my health.

As to that first one, we all have our stories of government waste.  We know they exist.  But on the whole, how bad a job do they do?  The two common examples are the DMV and the Post Office.  I know the story goes the DMV is inefficient, but for the most part, my experiences there have been quick and painless.  One license renewal was a pain, because they had had a number of people quit recently so there were long lines.  But that can happen anywhere.  And I barely go to the DMV any more, I can do all of that online.  Further, there’s millions of cars on the road in America, and most of them are registered, inspected, and insured (at least in those states where its required).  Heck, you want an example of government efficiency; the DMV knew the very moment I lost my auto insurance at one point due to a late payment, back when I was having money trouble, and they were on my backside instantly.

The post office gets a bad rap because they raise rates frequently, and every now and again someone snaps, and there are lines around the holidays.  But seriously.  Every day but Sunday, they come to your house and drop off your mail.  They pick up mail from your house at the same time.  They move things across the nation in 1 to 5-6 days, depending on how much you pay, or maybe a few weeks if it’s a larger package and you pay the lowest rate.  There are private corporations that do this, but the service is about the same (except they don’t always pick up) and the price is about the same – for packages.  Or letters can be sent via the internet, which is all on computers.  For moving physical stuff around, it is actually hard to really beat the post office.  Obviously, there are some things that Fedex and UPS do better, and some they do worse, but overall, the vaunted “private sector” doesn’t kick the government’s ass.

Social Security has never had a failure to process their payroll (individuals have no doubt fallen through the cracks- I’m merely saying as a whole, they’ve never messed up on a massive scale).  The military defends this nation and does their level best even when a President sends them in with no clear mission and lacking sufficient equipment – and trust me, I’d much rather have the military doing it than the private sector equivalents, who do nothing but scare the pants off me.  The fire department saves homes and the police save people.  Our national parks are generally awesome.

Do some departments cost a lot?  Sure.  Defense costs a lot, but having a weapon that works the first time, every time, and won’t hurt you if it fails costs a lot.  Heck, even normal objects cost a lot if they have to be safe for battle zones – go and watch the episode of West Wing episode “Process Stories” if you want to see why.  NASA costs a lot too, but since no one but governments and *billionaire* Richard Branson is sending people in to space – and he isn’t doing it regularly yet – I guess it’s just an inherently expensive proposition.  Could costs go down?  Sure.  And we should be looking to do so.  But some things just cost money.  Even health care costs money.  A medication may be 5 cents a pill today, but it probably costs millions or billions to create and test it.  Making it Governmental won’t change that aspect of health care, but it may make things more available to the people.

Oh, and yes, your taxes may go up.  Which always sucks.  Unless, of course, its offset by your insurance or other health care costs going down.  Which would only make sense.

If done right, which is admittedly a tricky proposition, there is no reason government run healthcare is inherently going to be poorly run.  To say that it is does a disservice to all our government offices that, frankly, we take for granted.  Unless government health care is run as efficiently and effectively as the United State Congress (under either party).  Then we’ll all be dead in a week.

JC Economy, Health care, Media, National Politics drugs, finance, Health care, taxes

Last week, a case involving a cancer-stricken child and a mother who was refusing chemotherapy made the national news.  Its hardly the first such case ever, though this one had the “sexiness” of the mother and her son fleeing rather than subjecting themselves to the court’s authority, at least for part of the time.  A fairly good, if rather basic, summary of the issues surrounding the case and cases like it appears today on CNN.com:

http://www.cnn.com/2009/HEALTH/05/28/treatment.parental.rights/index.html

I have a friend who I would say is very mixed, politically, but comes from a conservative background, who wrote a very intelligent and thought out argument against the court intervention in this case.  She made the point that allowing the courts to override a parental right based on a recommendation from a doctor is one very small step from doing the same to adults (probably starting with adults who have others making their medical decisions for them, but ending with you and me).  It is an important and scary point, and as my friend points out, it is the stuff of Orwellian nightmares.

I have to admit, my first reaction was different.  My first reaction was that the parents in this case are morons, and that their denial of life-saving procedures to the child was tantamount to abuse.  Of course, I am not a doctor, and I don’t understand what is going on with this child’s particular medical case.  I thought I had read that it was a fairly clear cut survivability issue – that without treatment, he was 99.9% likely to do quite soon, and with treatment, there was every chance he’d live the rest of his life fine and dandy.  Other things I’ve read since then have indicated I may have misunderstood, but I have to admit, I think I may have misunderstood the reality of the situation too.  I mean, is it really okay to do this to one child because he’s likely to survive if we take action, and not okay to another because he isn’t?  Does the degree make the difference, and if so, is there a clear line at which we intervene and on the other side of which we don’t?

I mean, as a society, we’ve already decided the state can override parental rights on all sorts of issues.  And yet, on others, we remain strangely silent.  You can take a child away from verbally or physically abusive parents, but as was pointed out to me, if you feed a child nothing but fast food all day long, the state does nothing.

As a society, we all want every child to be given every advantage.  At the same time, we don’t have any desire to take away the right to parents to raise their children the way they see fit.  We have nightmares about leaving children with parents who raise them to be full of hate or completely ignorant of the way to world works, and yet we at the same time are no more pleased by the vision of children raised by the state, uniformly, without such trivial things in the background like religion, compassion, or individuality.

All that cases like this really point out is how woefully inadequate our current systems are for handling such complex problems, while at the same time offering up no better solution.  Our current health care system?  Messed up at a remarkable number of levels.  Our current legal system?  The same.  Our social services?  Also the same.  Even our society.

We have become a nation that wants easy solutions.  We aren’t really capable of dealing with situations that have no easy answers.  All I know is, I want our children to be safe, healthy, and happy.  But those three words have such a wide meaning that there’s no easy way to meet that goal.

JC Health care, Society culture, Health care, parental rights

So, I’ve written, at times, about health care, and how I agree with Obama that it is part of what is causing our economic problems, and how I think that the government should, therefore, address it.  I don’t know exactly how, of course, as I am not a health care expert.

But I do think it contributes to our economic woes.  A case can be made that if a business didn’t pay for their employee’s health care costs, the bottom line for that business would be stronger.  GM is a strong example of this.  We all know that health care costs (as outlined in union contracts) are a huge part of why their vehicles are more expensive than comparable Japanese vehicles.  Small business resists requirements to provide employees health care for much the same reason, when your profits are razor thin, there is every chance that every cost is the one that will put you out of business.  Of course, if the Government pays for health care, then the businesses are still paying from their taxes, of course, but it seems like it could work better.

A trickier economic question would ask if our emergency health care – which we do provide free of charge to those who can’t afford it – would be less burdened if those who can’t afford it could get more preventative and early care, rather than waiting for it to get bad enough to go to an emergency room.

All that ignores, of course, the question of whether providing health care for Americans is a imperative of the government, in the same sense as providing security (police coverage) or safety (fire coverage).

Of course, there’s always the question of would it work better.  We all, for better or for worse, have a healthy distrust of the government.  After all, it seems like their bureaucracy makes everything it touches less efficient.  This is, in fact, one of the cornerstones of conservatism – that decisions – and money – are better off in the hands of the people than in the hands of the government.  We point to our own government programs and talk about how inefficient they are – hugely expensive military items, an department of education that can’t graduate students who can read, civil service rules that keep out qualified applicants and hire unqualified ones and so on.  And we point to other nation’s health care systems – Canadians waiting months for life-saving measures, the “brain drain” as doctors leave for other nations where they can make more money, etc.

 But is our own nation’s government that bad?  Social Security has been chugging along effectively for decades now, and the problems that are coming up for that program have nothing to do with the effectiveness of their processes but the problems with their funding pool.  Your local fire department generally keeps fires from destroying whole neighborhoods or dies trying – sometimes literally.  Most police departments across the nation effectively serve and protect.  Even departments that routinely get smacked for inefficiency or corruption are, at their core, effective.  It may or may not cost the Pentagon 300 dollars for an ashtray and 300 million for a fighter place, but our men and women overseas do every job we ask of them and that we aren’t willing to do.

As for those foreign governments?  First of all, when you actually talk to a Canadian, they will generally give their health care system a thumbs up.  The stories that get played in America about how dangerous national health care is are cherry picked to scare you. 

I admit I don’t have a great solution to the brain drain problem, but I bet you someone does.  I bet you we can have national health care and still make doctors well compensated for their hard work becoming doctors; I bet we can pay for their education and their service if we try. 

And if you are looking at foreign nations to find out how awful their national health care systems are, don’t forget to look at the Americans who are travelling to foreign nations to have their health care done, the so called medical tourism phenomenon – http://medicaltourismguide.org/

Lots of people, including at least one commenter on this very blog, think that universal health care won’t work in America.  America is, essentially, the only government with a “modern” economy that doesn’t provide health care to the people in its nation.  That may not quite be here or there as far as an actual argument, but it should make you ask one thing: if it didn’t work, why would so many other countries offer it to their people?

JC Health care, National Politics Health care